Author: Laura Ness

Ambassador Thomas Johnson-Medland joins Attorney General Josh Shapiro and other officials and advocates during a press conference in support of a drug disposal bill.

This quarter, Hearts for Home Care (H4HC) Ambassador and Pocono Hospice Director Thomas Johnson-Medland represented BAYADA at a press conference with Senator Lisa Baker and Attorney General Josh Shapiro as they celebrated the passing of legislation which will protect Pennsylvanians by allowing hospice professionals to dispose of prescription drugs after a loved one dies.

Throughout the legislative process, Thomas and other BAYADA advocates vocally supported Senator Baker’s bill and were active in ensuring it reached the finish line on behalf of all of our staff, clients, and their families.

Thank you Tom for being such a great representation of the home care industry!

Below, Please see HPI Recruiter Associate’s take on why she decided to take her advocacy to the next step by becoming a Hearts for Home Care Ambassador.

BAYADA Home Health Care Associate and Hearts for Home Care Ambassador Kimberly Gardner (left) and CEO David Baiada (right) at the Pennsylvania Home Care Association’s Advocacy Day in Harrisburg with Kim’s client and disability rights advocate Mark Steidl (center).

“I wanted to become a Hearts for Home Care Ambassador so that I can advocate for families so that they in turn can enjoy peace and comfort in their home, and so they can hopefully live as normal of a life as possible.

I have worked in the health care field for over 12 years, and specifically as a Certified Nursing Assistance within hospice for seven years. I was able to see first hand while working with my clients in the nursing home the importance of caring for clients in general. The clients all had one thing in common: “They wanted to go home.” There is a lot of turnover in health care, and it was sad to see when some of the residents were not getting the proper care they should have been getting. I can say it was hard to watch at certain times.

It wasn’t until I started working for BAYADA Home Health Care that I was able to experience so much more opportunity to impact clients’ lives on a daily basis, particularly through advocacy. Working at BAYADA has opened up my eyes to lawmakers’ roles in home health care, and the importance of employees advocating for their clients. We are their voice and we must stand up for them!

I enjoy talking to legislators and pushing for home care in all ways possible. It is an experience that I not only appreciate, but truly enjoy doing. I attended my first Advocacy Day in May of 2018 and it wonderful experience. It was great to see how everyone came together for the same cause. I appreciate all of the support from our Government Affairs Office (GAO) and I look forward to continuing to advocate for our clients with BAYADA.”

The Government Affairs Office (GAO) and our PA Hearts for Home Care Ambassadors and fellow advocates worked hard to ensure our legislators understood that deemed eligibility would allow home care providers to provide care to seniors who appear that they will be financially eligible for home care services. This issue became very well-known among our legislators and was eventually known as a “common sense” and “win-win” issue.

As a result, in the closing days of session the PA General Assembly led a flurry of activity for deemed eligibility. We saw:

HB 1829 and SB 912, identical bills in support of deemed eligibility, unanimously passed in the Senate Human Services Committee

SB 912 passed unanimously in the Senate Appropriations Committee

SB 912 passed unanimously in the full Senate.

So what happened?

Legislation which would provide victims of abuse from catholic clergy took the attention of the entire legislature in the waning days of session. As a result of differing opinions and upcoming midterm elections, competing interests took hold and the deemed eligibility bills and many others were left without resolution.

What’s next?

It is very rare for legislation to fully pass in only one session, especially something as innovative as deemed eligibility. The fact that we got two bills almost fully through the process deserves to be celebrated. PA GAO will continue to advocate for this issue and look forward to having the legislation reintroduced next session.

Thank you to our advocates and the many legislators who supported this bill! Please contact me if you’re interested in advocating for our goals next session!

The PA Aging and Older Adult Services committee recently held a two-day hearing on HB 2549, which would amend the Older Adult Protective Services Act (OAPSA) to remove some of the challenges that home care providers face when hiring new employees.

Most notably, if passed, the bill would: Establish new rules and procedures for hiring an individual with a criminal history in the long-term sector and would list out specifically prohibited offenses. It would establish a tier for specific crimes, with each tier having a different length of ban. Lastly, the bill would also require financial institutions to educate their employees on the signs of financial abuse in older adults, as well as the process to report abuse.

During the hearing, Patricia Rodgers, President of the Pennsylvania Homecare Association (PHA) testified, stating, “Homecare is one-to-one-care… Our homecare aides are lifelines for the individuals they serve and we must ensure that they are qualified and competent…Having strong, concise and effective guidance in OAPSA will help support agencies’ goals of keeping that person safe at home.” Please see PHA’s press release for more information on the bill’s merits.

BAYADA and PHA have been working with the chair of the Aging and Older Adult Services Committee to ensure the legislation proposed raises industry standards while limiting the burden on providers. Because session has now concluded without HB 2549’s passage, this legislation will need to be reintroduced for consideration during the upcoming 2019 legislative session. We look forward to being involved—If you are interested in advocating for this bill and other protections for our industry, contact me.

In January 2018, 11,000 older adults and people with disabilities in Southwest PA who had been receiving Medicaid long term services and supports in the community, started receiving those services, including personal assistance services (PAS), from one of three Community HealthChoices (CHC) managed care plans: UPMC Community HealthChoices, PA Health & Wellness, and AmeriHealth Caritas.

For the first six months of the roll-out, CHC participants were entitled to keep receiving the same amount of long term services and supports they had been receiving prior to CHC with the providers they had been using. This six-month “continuity of care period” in the Southwest ended on June 30.

PHLP has been hearing from CHC participants about actions CHC plans are taking to reduce services in this post-continuity of care period. After speaking with these participants and reviewing CHC plan notices and service plans, it appears CHC plans are violating the rights of participants and not following the terms of their agreement with the state.

The problems CHC participants are experiencing include deficient notices reducing services they had been receiving and a lack of appropriate person-centered service planning. Most of the problematic service reduction notices involve PAS.

Notices Sent to Participants Are Inadequate: CHC plans are sending reduction and denial notices to participants that do not include any explanation or reasons for why services are being reduced or why requests for new or increased services are not approved. CHC plans are required to send their members written notice of reductions and denials of services. These notices must detail the reasons for the change or denial. Justifications, which PHLP has documented, like “you have been assessed to need less PAS hours” or “the services are not medically necessary” without any further explanation are insufficient. The CHC participants who have contacted PHLP are receiving notices that do not explain why the CHC plan decided they do not need the services, what has changed to warrant a service reduction, or how requested services are not medically necessary.

Lack of Person Centered Planning: Person-centered service planning is at the core of CHC. It is supposed to be a process in which the CHC participant, working with their service coordinator and anyone else the participant wants involved, identifies her needs, preferences, and goals. This informs the development of a service plan. The person-centered service plan process is so central to the CHC program that home and community-based services, including PAS, received under continuity of care cannot be changed until the process is complete. Yet, PHLP has heard from participants who are being denied services when they have not gone through the service planning process. Others have gone through the process but have not been given a copy of the service plan that was developed. Still others have had incomplete service plans, such as unsigned plans or not having any goals listed at all.

PHLP has shared its concerns with the Department of Human Services (DHS)and will continue to do so as new examples of problems surface. DHS reacted swiftly to the information and specific examples PHLP provided. All three CHC plans have been put in corrective action. As a result, the CHC plans are retraining service coordinators on person-centered planning and submitting to the state for review all notices issued to members when services are denied or reduced. DHS has assigned staff to review every service denial notice until it is satisfied that each CHC plan is complying with the CHC agreement. Moreover, DHS and staff from its Office of General Counsel are meeting in July with senior leadership from each CHC plan to review the minimum content required for a service denial notice when plans deny or reduce a CHC participant’s services.

However, regardless of he corrective actions described above, vigilance from CHC participants and their providers in the Southwest is needed to ensure the CHC program moves into its next phase in the region in a way that does not harm participants but assures their needs are met. CHC participants, their family members or other supports, and providers are encouraged to read notices denying or changing services carefully. These notices include information about how to file an appeal. CHC participants should appeal decisions if they do not agree with them. Appealing quickly will ensure they continue to receive services at the previously approved level while they go through the appeal process.

PHLP strongly encourages CHC participants or their providers or advocates to call the PHLP Helpline at 1-800-274-3258 or email us at staff@phlp.org for advice or help with their appeal. Information about appealing a CHC decision can also be found on PHLP’s website (www.phlp.org). You can also sign up here for the second part of PHLP’s CHC Appeals webinar series which will be held on July 17.

For the first time in over four years, the Pennsylvania General Assembly completed the FY 2018-2019 budget ahead of the constitutionally mandated June 30 deadline.

During our Advocacy Day in Harrisburg, House Appropriations Chairman Stan Saylor announced he was working to get us an increase in personal assistant services (PAS) provided under the Office of Long-Term Living. This was Pennsylvania’s primary legislative priority for BAYADA in 2018.

After this announcement the Government Affairs Office (GAO), home care advocates, and the Pennsylvania Homecare Association (PHA) worked at breakneck speeds to make it a reality. In the month leading up to the final budget we met with Chairman Saylor and staff several times, spoke with key leadership, and touched the entire legislature several times. Unfortunately, the legislature passed, and the Governor signed, the FY 2018-2019 budget without this increase.

We have been working towards this increase since 2014 and we have made incredible progress. We will continue to ensure this remains top of legislators’ minds. This summer we will begin our work to ensure we receive a rate increase in next year’s budget.

Thank you for your support, and for the time that you took participating in our efforts, whether it was by emailing legislators through our action alert, which generated over 430 emails to legislators, or through your attendance at PHA’s Advocacy Day in Harrisburg. All of these efforts showed legislators just how widespread and important this issue is, and we have heard directly from many who told us how impactful our efforts continue to be.

BAYADA employees, clients, and families gather in Harrisburg to advocate for better home care policies.

On May 22, 160 employees donned their best “BAYADA red” and gathered at the Pennsylvania state capitol in Harrisburg. Employees came from 30 divisions, 18 offices, and 9 practices, with the common goal of shining light on the importance of home care.

Along with BAYADA employees and other industry professionals, home care clients and family members joined in the efforts as well. We attracted big hearts: Each individual attended because they felt that it was their duty to advocate on behalf of themselves, their staff and clients, or their loved ones. When advocates share their unique and compelling home care experiences with legislators, it enables legislators to remember our clients’ faces and stories when they make policy decisions that affect care.

Hearts for Home Care advocates met with more than 200 legislators to educate them on the needs of the home care industry. They advocated for changes in hiring standards within the Older Adult Protective Services Act, a need for deemed eligibility to keep more seniors at home, and an increase in pay for direct home care workers.

If you missed out on 2018’s Advocacy Day, there are still opportunities to connect with legislators and to be a voice for those who cannot advocate for themselves. Employees can set up and host home visits, legislative office visits, or simply make phone calls or send emails to demonstrate the importance of home care to legislators. Please reach out to me at lness@bayada.com to learn about the many ways you can connect with legislators in support of our goals.

Home care employees, clients, and families participate in Advocacy Day in Harrisburg, PA

Last Tuesday, May 22, more than 200 home care employees, clients, and clients’ family members came together with the Pennsylvania Homecare Association (PHA) for their annual Advocacy Day in Harrisburg, PA. Advocates came from a variety of agencies and backgrounds across the state to discuss the importance of home care with their legislators.

Advocates met with more than 200 legislators to educate them on the need for deemed eligibility to allow more of Pennsylvania’s seniors to remain at home, increasing pay for home care workers, and the importance of maintaining strict hiring standards within the home care industry. Advocates used their passion and first-hand experience to demonstrate the necessity of these initiatives to legislators and made lasting impressions through their stories.

And advocates’ hard work paid off! During PHA’s press conference, Rep. Stan Saylor, Chair of the House Appropriations Committee, stated that he would support a rate increase for Medicaid personal assistance services (PAS). Additionally, PHA has been in touch with staff from the Senate Appropriations and Health Committees about bringing deemed eligibility legislation to the Senate floor for a vote.

Advocacy is a vital part of a democracy and allows for legislators to hear about issues their constituents routinely face from a different perspective. Through BAYADA Home Health Care’s Hearts for Home Care Ambassador Program, BAYADA employees are educated on the issues facing their states, strategies to advocate effectively for home care staff and clients, and the tools necessary to make a lasting impression.

Advocacy is just another way of ensuring the highest quality care is provided to those who need it. Below, please find quotes from some of those who attended this year’s Advocacy Day on why they chose to participate, as well as a reaction from Pennsylvania State Representative Donna Bullock.

“When I was approached several years ago to be a Hearts for Home Care Ambassador, I was hesitant. There is so much about politics I don’t understand, but what I do believe in is what we do at BAYADA! We have such an amazing opportunity to be the voices for those who don’t have them and if we believe in what we are speaking too, it’s really not that hard! Advocacy, to me, just means I’m standing up for what I believe in and sharing it with those who have the ability to make change.” –PA Hearts for Home Care Ambassador Christine Detweiler

“Advocacy in home care is really about our government representatives seeing the faces and hearing the voices of the people. These interactions help legislaotrs know what our needs are so they can do their best to help my family and the many other families who need a nurse or an aide at home.” –Amy Zemek, Mother of client Alexa D.

“What I found special about attending Advocacy Day in Harrisburg was that the real people we serve every day did not need to rely on anyone else to tell their story. They were allowed to advocate for themselves. We just need to listen more and allow their powerful story to speak loud and clear. Advocacy Days allow those we serve the opportunity to tell their powerful story and for our elected officials to hear and listen to their stories, because those we serve can often advocate for themselves far better than we can.” –Home Care employeeJarod Champeaux

“What is advocacy to me? Advocacy is the look on the faces of the people we serve, the love, the commitment, and the lives we change by the amazing work that we do!” -PA Hearts for Home Care Ambassador Candice Proctor

“Affordable healthcare is a top priority of mine and is critical in safeguarding the well-being of our communities. I share BAYADA’s Home Health Care’s passion and devotion to ensuring anyone who qualifies for home care service receives the proper treatment they need and deserve. I thank them along with the many other advocates for traveling all of the way to Harrisburg to fight for our cause. Together, we can instill change, protect families and achieve our goals.” –State Representative Donna Bullock, 195th District

Thank you to the many home care employees, clients, and families that participated in Advocacy Day!

The Pennsylvania Health Law Project (PHLP) is a statewide center of legal expertise and advocacy devoted to increasing access to publicly-funded health care coverage and services. PHLP provides free advice and representation to individuals across the state who are experiencing problems with their Medical Assistance (MA) services, including their home health services.

If MA denies, reduces, or terminates a client’s home health services, the client has a right to challenge that denial by filing an appeal.

The MA appeal process can be complicated. There are multiple levels of appeal, including a grievance, an external review, and a fair hearing. PHLP understands that families often don’t have the time to take on these appeals on their own, or they may feel confused, daunted, or frustrated by the

process. PHLP will work with families, along with their home health agency, doctors, and other providers to try and get the denial overturned through the appeal process. In some cases, PHLP may even go with the family to the appeal hearing.

There is no income limit to qualify for help from PHLP and all services are completely free of charge.

If your client’s MA services are denied, please urge them to call PHLP’s Helpline at 800-274-3258 for assistance. More information can be found on PHLP’s website at www.phlp.org.

Joe Davis has been the director of BAYADA’s State College (STC) pediatric office for the past six years. In addition to the many responsibilities that come with running a busy service office, Joe always takes time to advocate on behalf of his staff and clients.

As his office’s Hearts for Home Care Ambassador, part of his role is to inform state legislators about BAYADA and the home care industry and to educate them about our legislative priorities. Joe has hosted state Representative Kerry Benninghoff in the STC office to discuss the importance of home care within Rep. Benninghoff’s district and throughout the state. He also recently met with state Senator Jake Corman to advocate for deemed eligibility and a rate increase. Joe hopes to someday serve on a government-appointed committee to represent home care.

Thank you, Joe, for all your advocacy efforts. Your hard work on behalf of your staff and clients serve to create a better tomorrow for all of BAYADA’s staff and the many clients and families we serve.